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This article is the first part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the importance of physical activity and symptom management. Strong evidence supports the use of exercise for cancer-related fatigue and indicates that lymphedema is not exacerbated by exercise. Moderate evidence supports the use of yoga to relieve anxiety and depression and indicates that exercise as a whole may contribute to a return to precancer levels of sexual activity. The results of this review support inclusion of occupational therapy in cancer rehabilitation and reveal a significant need for more research to explore ways occupational therapy can positively influence the outcomes of cancer survivors. Part 2 of the review also appears in this issue.
Cancer may result in impairments, activity limitations, and participation restrictions (Fialka-Moser, Crevenna, Korpan, & Quittan, 2003; Grov, Fosså, & Dahl, 2010; Hewitt, Rowland, & Yancik, 2003; Hwang, Lokietz, Lozano, & Parke, 2015). Cancer survivorship covers the time from diagnosis until the end of life (National Cancer Institute, 2015). Cancer survivors may have declines in functioning and participation in areas ranging from mobility to return to work (Hwang et al., 2015; Kroenke et al., 2004; Nomori, Watanabe, Ohtsuka, Naruke, & Suemasu, 2004). Adults with cancer experience decreased levels of physical functioning and participation in social, work, and leisure activities compared with before diagnosis regardless of the kind of cancer or type of treatment received (Ganz et al., 2004; Grov et al., 2010). The lowest function is experienced after treatment, with function increasing over time, although functional recovery is moderated by pain and co-occurring diseases (Hwang et al., 2015; Ko,Maggard, & Livingston, 2003).
The Institute of Medicine and National Research Council have strongly suggested that cancer survivor research should include expanded exploration of alternative models of survivorship care, such as supportive care and rehabilitation programs (Hewitt, Greenfield, & Stovall, 2006; Institute of Medicine, 2013). However, a major problem in the U.S. health care system is that cancer survivors are frequently not referred for and do not receive specialized rehabilitation care appropriate for their diagnosis (Cheville, Troxel, Basford, & Kornblith, 2008; Pergolotti, Cutchin,Weinberger, &Meyer, 2014). Rehabilitation...